Effect of intranasal dexmedetomidine on the reversal of rocuronium-induced residual neuromuscular blockade with sugam-madex in pediatric patients
Objective To explore the effect of intranasal dexmedetomidine on the reversal of rocuronium-induced residual neuro-muscular blockade with sugammadex in children.Methods A total of 64 children,American Society of Anesthesiologists grade Ⅰ orⅡ,aged from 1 to 9 years,who were scheduled for lower abdominal surgery from April 2020 to November 2020,were selected.Accord-ing to the random number table method,they were divided into two groups(n=32):an experimental group and a control group.Before sur-gery,they were intranasally administered with dexmedetomidine at 1.0 μg/kg or with an equal volume of normal saline,respectively.Dur-ing surgery,train-of-four(TOF)stimulations were performed using a neuromuscular blockade monitor.After surgery,the patients were given sugammadex at 2.0 mg/kg in patients when TOF T2 appeared again during neuromuscular block monitoring.When TOF ratio(TO-FR)was recovered to 0.9,their following data were recorded,including general information,time to operation,temperature after surgery,time to extubation and the length of post-anesthesia care unit(PACU)stay.Meanwhile,the bispectral index(BIS)immediately before neu-romuscular block,heart rate,as well as 2 min and 5 min after antagonism,heart rate,systolic blood pressure,diastolic blood pressure and the incidences of rash,nausea,vomiting and agitation during the recovery period were recorded.Results There was no statistical dif-ference in general information,time to TOFR recovery to 0.9,time to operation and temperature after operation in the two groups(all P＞0.05).The experimental group showed significantly extended time to extubation time and length of PACU stay(all P＞0.05).Compared with the control group,the experimental group presented lower BIS immediately before antagonism and 2 min after sugammadex admin-istration(all P＜0.05),with reduction in the systolic blood pressure immediately before sugammadex administration(P＞0.05);and there was no statistical significance in the indexes between the two groups at other time points(all P＞0.05).There were no reports concerning rash,nausea and vomiting in the two groups during the recovery period.The incidence of agitation in the experimental group was signifi-cantly lower than that in the placebo group(P＞0.05).Conclusion A single nasal dose(1 μg/kg)of dexmedetomidine before surgery does no extend the reversal of 2.0 mg/kg sugammadex for rocuronium-induced residual neuromuscular blockade in children.
ChildrenDexmedetomidineIntranasal deliverySugammadexResidual neuromuscular blockadeRe-versal time
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